Coho Health Advanced Functional Testing

Getting the right test at the right time can identify the true, underlying causes of sub-optimal health, pinpointing specific imbalances or sub-optimal markers (e.g. hormones, vitamins, minerals, enzymes, pathogens).

Combined with an expert interpretation appointment, and a bespoke personal action plan as standard, our private testing means that you can feel and perform better, faster, leading to outstanding health and wellbeing for life.

Our Easy 4 Step Process

1. Order your test kit online

2. Collect your sample

3. Send your sample to the lab

The lab will take payment for the test directly

Your test results will come to Coho Health

4. Book & pay for your expert interpretation appointment with an Coho Health practitioner

Complete & return our pre-interpretation health forms

Get your personal interpretation, report & action plan

Testing Areas

Click the button to jump straight to the test area you’re interested in, or scroll down to see all tests

Blood Draw Services

The unique way in which we work, combined with our relationships with the finest testing laboratories in the world (both here in the UK and in the USA), means that you can get the right test, at the right time.

Appropriate testing, together with the correct interpretation and our advanced protocols, can help you look, feel and perform better in record time.

Functional testing at Coho Health includes an interpretation appointment (either in person at one of our clinics, or via virtual appointment), plus a report that includes our recommendations, and an action plan. Due to the complex nature of test interpretation, we do not provide stand alone testing without interpretation.

Test List

Hormonal health

Dutch Complete Hormones

Test fee (pay lab directly)

£286.00

Interpretation fee (payable to Coho once test results are available)

£120.00

Sample type Number of samples Test turnaround time
Urine
4
14 days

Extensive profile of hormones; oestrogen, progesterone, testosterone, stress hormones, melatonin and metabolites. Vitamin B12, B6, B2 and glutathione.

 

This advanced hormone testing range was developed to improve on the available hormone testing options. In their words DUTCH offers the most extensive profile of sex and adrenal hormones along with their metabolites.

 

Additionally, the daily (diurnal) pattern of free cortisol is included along with melatonin. This unique combination of clinical information is not available by any other method.

 

Effective Monitoring: DUTCH testing was specifically made to be optimally effective for most forms of hormone replacement therapy. Unique methods are used for improved monitoring of oral progesterone and vaginal hormones.

 

Easiest Patient Collection: Patients collect just four or five dried urine samples over a 24-hour period. Dried specimen shipments are convenient worldwide. Dried samples are stable for several weeks.

 

Analytical and Clinical Validation: Precision Analytical testing methods go through a rigorous validation process to verify accuracy, precision, recovery, linearity, etc. We pride ourselves in relentlessly pursuing the most accurate and precise techniques available for testing. See the following data (back side) to support the analytical and clinical validation of this powerful new testing model.

Comprehensive Adrenal Stress Profile

Test fee (pay lab directly)

£107.00

Interpretation fee (payable to Coho once test results are available)

£80.00

Sample type Number of samples Test turnaround time
Saliva
4
14 days

Adrenal stress hormones – cortisol and DHEA. Includes immune marker – secretory IgA.

 

The Adrenal Stress Profile is a convenient, noninvasive salivary assay that evaluates the bioactive levels and interrelationship of the body’s important stress hormones, cortisol and DHEA. This profile serves as an insightful tool for uncovering biochemical imbalances that can be associated with anxiety, depression, chronic fatigue, obesity, dysglycemia, and a host of other clinical conditions.

 

Cortisol: Cortisol is released in large amounts in response to physical, physiological, and/or psychological stressors. A glucocorticoid response that is elevated, extended, or inadequate can impair a person’s adaptation to stress, increase or decrease HPA-axis activity and is considered a health risk. Due to the circadian pattern of cortisol release, sequential timed measurements of cortisol provide the best tracking of overall cortisol production.

 

DHEA: DHEA, in contrast to cortisol, exerts mostly anabolic actions and balances the body’s stress response. DHEA functions to provide substrate for the synthesis of sex hormones, guards against degenerative conditions associated with aging, influences immune function and energy production, and affects insulin sensitivity, thyroid function, and protein synthesis. Although both DHEA and cortisol are produced by the adrenal cortex, they exhibit many opposing actions.

 

Why Use the Adrenal Stress Profile?

 

Imbalances in the adrenal hormones cortisol and DHEA can adversely affect:

 

  • Mood
  • Sleep
  • Immune defence
  • Thyroid function
  • Weight control
  • Resistance to stress
  • Energy
  • Cardiovascular health

 

The Adrenal Stress Profile uncovers abnormal patterns of cortisol release that can be addressed with customised therapeutic interventions.

 

  • Hormone Therapy – Cortisol, DHEA, and Melatonin
  • Targeted Supplementation – nutrient and botanical support
  • Dietary/Lifestyle Changes

– Adequate protein/slow-release carbohydrate diet

– Stress-reduction techniques

– Exercise

 

  • Four easy at home salivary samples collected throughout the day allow for circadian rhythm assessment of cortisol release along with DHEA.

DUTCH Cycle Mapping

Test fee (pay lab directly)

£381.25

Interpretation fee (payable to Coho once test results are available)

£120.00

Sample type Number of samples Test turnaround time
Urine
9 (over 21 days)
25 days

Oestrogen and progesterone measurements taken throughout the menstrual cycle to assess follicular, ovulatory and luteal phases.

 

For some female patients, testing on just one day of the month is not enough. Women with infertility, irregular cycles or no menstrual bleeding due to an ablation or partial hysterectomy can benefit from the DUTCH Cycle Mapping. This profile helps evaluate hormones throughout a full menstrual cycle. Nine targeted oestrogen and progesterone measurements provide important details on a patient’s hormone levels in the follicular, ovulatory and luteal phases of the cycle. Easily collected in the comfort of your own home, samples are sent to our lab to be processed. The report provides a detailed analysis, ensuring more individualised treatment by your healthcare provider.

 

The kit includes:

• Easy directions and filter paper collection strips

• Requisition form for patient information, pertinent supplements, medications, hormone replacement and a health questionnaire

• Sealable return envelope

 

The results include:

• Nine (9) targeted oestrogen and progesterone measurements taken throughout the cycle to characterise the follicular, ovulatory and luteal phases

• Graphical representation of results and embedded video tutorials to assist in the hormone test analysis to share with your medical provider

 

*Cycle Mapping can also be combined with the DUTCH Complete for a more comprehensive hormone panel.

Rhythm Plus: Comprehensive FEMALE Hormone Profile

Test fee (pay lab directly)

£235.00

Interpretation fee (payable to Coho once test results are available)

£120.00

Sample type Number of samples Test turnaround time
Saliva
16 (over full cycle)
16 days

Oestradiol, progesterone, testosterone (testing spans a full 28 day cycle), plus stress hormones.

 

The Rhythm Plus™ hormone test is a comprehensive assessment of estradiol, progesterone, and testosterone spanning a full 28 days. Additionally, this hormone testing profile includes the Adrenocortex Stress Profile and the Comprehensive Melatonin Profile to reveal how the sex hormones are influenced by cortisol, DHEA, and melatonin. Hormone imbalances revealed in this hormone test can help illuminate root causes of disorders such as premenstrual syndrome (PMS), infertility, and menstrual irregularities.

 

Hormonal balance is the key. Research has long shown that fluctuating levels of estradiol, progesterone, and testosterone play a major role in a woman’s overall health.

 

Hormone imbalances can affect:

 

  • Menstrual cycle
  • Mood swings
  • Sleep patterns
  • Appetite level
  • Sex drive

Chronic hormonal imbalances are implicated in disorders such as:

 

  • PMS
  • Anovulation
  • Infertility
  • Breast cancer
  • Amenorrhea
  • Endometriosis
  • Polycystic Ovary Disease
  • Osteoporosis

 

Saliva hormone testing provides a thorough analysis of estradiol and progesterone over a full 28 day cycle. Testosterone is measured once from the 28th day specimen. By utilising 11 saliva samples for analysis, the relationship and balance of these essential hormones are analysed more precisely through time. The levels of oestradiol and progesterone, as well as the ratio between the two, are clearly graphed for easy reference and patient education.

 

Unlike serum measurements that typically reflect both bound and unbound fractions of hormones, salivary samples represent only the free (unbound) bioavailable fraction of hormone. Factors that affect binding globulin such as obesity and thyroid function do not influence test results with false high or low test levels.

 

Rhythm Plus™is a hormonal test indicated for both premenopausal and perimenopauseal women not currently supplementing with hormones. An analysis of oestrogen, progesterone and testosterone can reveal ovulatory function and trends in hormone production. Hormonal imbalances such as unopposed oestrogen, high follicular progesterone, anovulation and luteal phase defects are easily identified. This hormone test is especially useful in treatment of patients with chronic gynecologic disorders. Additionally, Rhythm Plus includes a circadian analysis of cortisol, melatonin, and an assay of DHEA.

FunctionalDX MALE Profile

Test fee (pay lab directly)

£310.00

Interpretation fee (payable to Coho once test results are available)

£120.00

Sample type Number of samples Test turnaround time
Blood (centrifuge)
1
10 working days

Comprehensive health screen: white blood cells, red blood cells, cholesterol profile, fasting glucose, inflammation, iron, vitamin D, thyroid hormone, kidney profile, liver function tests, testosterone, estradiol, progesterone, SHBG, DHEA-S, PSA.

FunctionalDX FEMALE Profile

Test fee (pay lab directly)

£334.00

Interpretation fee (payable to Coho once test results are available)

£120.00

Sample type Number of samples Test turnaround time
Blood (centrifuge)
1
10 working days

Comprehensive health screen: white blood cells, red blood cells, cholesterol profile, fasting glucose, inflammation, iron, vitamin D, thyroid hormone, kidney profile, liver function tests, testosterone, estradiol, progesterone, testosterone, LH, FSH, SHBG.

MALE Hormone Profile (TDL)

Test fee (pay lab directly)

£136.00

Interpretation fee (payable to Coho once test results are available)

£80.00

Sample type Number of samples Test turnaround time
Blood
1
1 day

FSH, LH, Testosterone, Free Androgen Index, Prolactin, SHBG.

FunctionalDX Thyroid Core (+ antibodies)

Test fee (pay lab directly)

£213.00

Interpretation fee (payable to Coho once test results are available)

£120.00

Sample type Number of samples Test turnaround time
Blood (centrifuge)
1
10 working days

Health screen: white blood cells, red blood cells, cholesterol profile, fasting glucose, inflammation, iron, vitamin D, thyroid hormones (TSH, T3, T4), anti-TPO, anti-peroxidase, liver function tests, vitamin D

Digestive health

GI Effects Comprehensive Stool Profile

Test fee (pay lab directly)

£355.00

Interpretation fee (payable to Coho once test results are available)

£120.00

Sample type Number of samples Test turnaround time
Stool
3
17 days

Markers specific to digestion, absorption, bacteria, yeast, parasite and inflammation. Go to test for bloating, indigestion, abdominal pain, diarrhoea, constipation, eczema, psoriasis, acne, autoimmune conditions, inflammatory conditions, weight loss/gain.

 

The GI Effects® Comprehensive Stool Profile is an advanced stool test that provides immediate, actionable clinical information for the management of gastrointestinal health. Utilising cutting-edge technologies and biomarkers, this test offers valuable insight into digestive function, intestinal inflammation, and the intestinal microbiome.

 

  • GI Effects is a comprehensive assessment of complete GI health, assessing the root cause of most gut complaints.
  • Genova uses a combination of PCRculture, and microscopic methods to ensure any and all relevant organisms are identified.
  • Genova recovers live organisms (yeast and bacteria) for susceptibility testing and improved treatment options.
  • Genova measures metabolomics and can assess the interaction between the microbiome and its host.

 

The GI Effects Comprehensive Stool Profile can reveal important information about the root cause of many common gastrointestinal symptoms such as gas, bloating, indigestion, abdominal pain, diarrhea, and constipation. This stool analysis utilises biomarkers such as Calprotectin to differentiate between Inflammatory Bowel Disease (IBD) and Irritable Bowel Syndrome (IBS). In addition, Genova’s GI Effects test can be used to evaluate patients with a clinical history that suggests a gastrointestinal infection or dysbiosis.

 

 

Gut microbes are codependent with one another and with their human host, and the health of one affects the other. A sizeable volume of research associates a dysbiotic, or imbalanced gut microbiome with multiple disease states both within and outside of the GI tract. The diverse metabolic activities of the microbiome ultimately impact the human host, and the activities of the human host ultimately affect the health of their microbiome.

The GI Effects Comprehensive Stool Profile Biomarkers

 

The biomarkers from the GI Effects Comprehensive Profile are reported using the DIG framework, providing key clinical information for three main gastrointestinal functional areas:

 

  • Digestion/Absorption:
    • Pancreatic Elastase-1 is a marker of exocrine pancreatic function.
    • Products of Protein Breakdown are markers of undigested protein reaching the colon.
    • Fecal Fat is a marker of fat breakdown and absorption.
    •  

  • Inflammation/Immunology:
    • Calprotectin is a marker of neutrophil-driven inflammation. Produced in abundance at sites of inflammation, this biomarker has been proven clinically useful in differentiating between Inflammatory Bowel Disease (IBD) and Irritable Bowel Syndrome (IBS).3,4
    • Eosinophil Protein X is a marker of eosinophil-driven inflammation and allergic response.
    • Fecal Secretory IgA is a marker of gut secretory immunity and barrier function.
    •  

  • Gut Microbiome:
    • Metabolic indicators, including short-chain fatty acids and beta-glucuronidase, demonstrate specific and vital metabolic functions performed by the microbiota.
    • Commensal Bacteria demonstrate the composition and relative abundance of gut organisms.
      • More than 95% of commensal gut organisms are anaerobic and are difficult to recover by traditional (aerobic) culture techniques.
      • GI Effects assesses a set of 24 genera/species that map to 7 major phyla.
    • Bacterial and mycology cultures demonstrate the presence of specific beneficial and pathological organisms.
    • Bacterial and mycology sensitivities are provided for pathogenic or potentially pathogenic organisms that have been cultured. The report includes effective prescriptive and natural agents.
    • Parasitology includes comprehensive testing for all parasites on every parasitology exam ordered.
      • GI Effects provides microscopic fecal specimen examination for ova and parasites (O&P), the gold standard of diagnosis for many parasites.
      • 6 Polymerase chain reaction (PCR) targets detect common protozoan parasites including Blastocystis spp. with reflex subtyping 1-9Cryptosporidium spp., Cyclospora cayetanensisDientamoeba fragilisEntamoeba histolytica, and Giardia. PCR for organisms is emerging as a highly sensitive method for infectious organism detection.

GI MAP

Test fee (pay lab directly)

£335.00

Interpretation fee (payable to Coho once test results are available)

£120.00

Sample type Number of samples Test turnaround time
Stool
1
5-7 days

Provides a DNA-based assessment of gut microbiome.

 

The Gastrointestinal Microbial Assay Plus (GI-MAP) is the first and only gut test in the world to be running full quantitative polymerase chain reaction (qPCR) on multiple GI targets, including pathogens, bacteria, worms, yeasts, parasites and comprehensive antibiotic resistant genes, alongside intestinal health, digestive, and immune markers.

 

What is The GI-MAP?

The GI-MAP assesses a patient’s microbiome from a single stool sample, with particular attention to microbes that may be disturbing normal microbial balance and may contribute to perturbations in the gastrointestinal (GI) microbiome or illness. It primarily uses multiplex, automated DNA analysis to give medical professionals a better view into the gastrointestinal microbiome. Combined with GI-health, digestive and immune markers, this is intelligent design, arming the practitioner with relevant clinical information, for best patient outcomes.

 

Methodology

Diagnostic Solutions Laboratory (DSL) uses a cutting-edge technology known as quantitative polymerase chain reaction (qPCR).

qPCR (or real-time polymerase chain reaction) combines amplification and detection into one step, and is one of the most powerful and sensitive gene analysis techniques available. It is used to quantify gene expression, analyse single nucleotide polymorphisms (SNPs), determine genotypes, detect pathogens, validate drug targets, and measure RNA interference.

Doctor’s Data Comprehensive Stool Analysis with Parasitology x3

Test fee (pay lab directly)

£276.00

Interpretation fee (payable to Coho once test results are available)

£120.00

Sample type Number of samples Test turnaround time
Stool
3 samples, over 3 days
14 days

Evaluates the status of beneficial and imbalanced commensal bacteria, pathogenic bacteria, yeast and parasites. Measures key markers of digestion, absorption and inflammation.

The Comprehensive Stool Analysis with Parasitology x3 is an invaluable non-invasive diagnostic assessment that permits practitioners to objectively evaluate the status of beneficial and imbalanced commensal bacteria, pathogenic bacteria, yeast and parasites.

Precise identification of pathogenic species and susceptibility testing greatly facilitates selection of the most appropriate pharmaceutical or natural treatment agents. Important information regarding the efficiency of digestion and absorption can be gleaned from the measurement of the faecal levels of elastase (pancreatic exocrine sufficiency), fat, muscle and vegetable fibres, and carbohydrates.

Inflammation can significantly increase intestinal permeability and compromise assimilation of nutrients. The extent of inflammation, whether caused by pathogens or inflammatory bowel disease (IBD), can be assessed and monitored by examination of the levels of biomarkers such as calprotectin, lysozyme, lactoferrin, white blood cells and mucus. These markers can be used to differentiate between inflammation associated with inflammatory bowel disease (IBD) and less severe inflammation that can be associated with irritable bowel syndrome (IBS) which is frequently due to the presence of enteroinvasive pathogens.

Cornerstones of good health include proper digestion of food, assimilation of nutrients, exclusion of pathogens and timely elimination of waste. To obtain benefits from food that is consumed, nutrients must be appropriately digested and then efficiently absorbed. Poor digestion and malabsorption of vital nutrients can contribute to degenerative diseases, compromised immune status and nutritional deficiencies. Impairment of the highly specific nutrient uptake processes, or compromised GI barrier function, as in “leaky gut syndrome,” can result from a number of causes including:

 

  • Low gastric acid production
  • Chronic maldigestion
  • Food allergen impact on bowel absorptive surfaces
  • Bacterial overgrowth or imbalances (dysbiosis)
  • Pathogenic bacteria, yeast or parasites and related toxic irritants
  • The use of NSAIDs and antibiotics

Impairment of intestinal functions can contribute to the development of food allergies, systemic illnesses, autoimmune disease, and toxic overload from substances that are usually kept in the confines of the bowel for elimination. Assessing the balance within the gut gives a look through a window that is often overlooked in chronic long-term health conditions.

Comprehensive Parasitology Profile (CP)

Test fee (pay lab directly)

£160.00

Interpretation fee (payable to Coho once test results are available)

£80.00

Sample type Number of samples Test turnaround time
Stool
1
16 days

Evaluates the status of beneficial and imbalanced commensal bacteria, pathogenic bacteria, yeast and parasites. Measures key markers of digestion, absorption and inflammation.

 

The Comprehensive Parasitology is a gastrointestinal stool test which evaluates for presence of parasites. Additionally the stool test evaluates levels of beneficial flora, imbalanced flora, pathogenic bacteria, and yeast. This stool test can help reveal hidden causes behind acute or chronic conditions that develop from parasitic infection or dysbiosis. The Comprehensive Parasitology stool test is ideal for patients with sudden changes in bowel pattern, especially for those who have been traveling abroad or camping.

 

Susceptibility to Parasite Infection:

 

It is generally assumed that travel to a Third World country or the occasional camping trips are prerequisites for acquiring a parasite infection. The truth is the combination of extensive worldwide travel, increasing immigration to the United States, day care centres (and other sources of easy transmission) — anyone is now susceptible. Diarrhoeal diseases, in fact, (bacterial as well as parasitic) constitute the greatest worldwide cause of morbidity and mortality.

 

Parasite Pathogenicity:

 

Various organisms are increasingly recognised for their potential pathogenicity. For example:

 

  • Giardia lamblia is the leading cause of intestinal parasitic infection in the United States. Only a few decades ago it was not considered pathogenic.
  • Cryptosporidium, a well-known pathogen in animals, was only recently identified as a human pathogen.
  • Blastocytis hominis is the most frequently observed fecal parasite. Its level of pathogenicity continues to be controversial.

 

Pathogenicity, in general, appears to vary depending on the parasite itself, host susceptibility, and the microbiological environment in which the parasite lives.

 

Parasitic Symptoms of Infection:

 

The most common symptoms of parasite infection are diarrhoea and abdominal pain. Other parasitic symptoms may include flatulence, anorexia, weight loss, fevers, chills, blood or mucus in the stool, and fatigue.

 

Parasitic Systemic Complaints:

 

We generally think of parasite infections as causing acute gastrointestinal symptoms. An increasing number of parasite cases feature systemic complaints not traditionally associated with parasites, such as:

  • Urticaria
  • Reactive arthritis
  • Chronic fatigue syndrome
  • Asthma
  • Constipation in individuals who are immune-compromised or whose intestinal flora is chronically imbalanced

 

Diagnosing Parasitic Infections:

 

The diagnosis of parasitic infections depends on the laboratory, with detection rates dramatically increasing with more sophisticated procedures. Genova Diagnostics’ Comprehensive Parasitology test profile uses the most technologically advanced procedures to accurately identify a wide range of protozoal parasites, including amoebae, flagellates, ciliates, coccidian, and microsporidia. Specimens are carefully analysed by highly-trained technicians using computer-enhanced microscopy, new staining procedures, and advanced immunoassay techniques. These accurate detection methods allow for increased detection rates, intensifying the awareness of the important relationship between parasitic infection and a broad spectrum of illnesses.

Small Intestinal Bacterial Overgrowth (SIBO)

Test fee (pay lab directly)

£121.00

Interpretation fee (payable to Coho once test results are available)

£80.00

Sample type Number of samples Test turnaround time
Breath
10
3 working days

Relevant in some cases of bloating, abdominal pain, constipation/diarrhoea, malabsorption, fatigue, ‘foggy brain’.

 

Normally the human small intestine contains fewer bacteria than the colon. Structural or functional disorders of the gastrointestinal tract can lead to bacterial overgrowth in the small intestine, with colonic bacteria proliferating in the ileum and jejunum.

 

Small intestinal bacterial overgrowth (SIBO), as it is known, is characterised by steatorrhea and diarrhoea, together with vitamin deficiencies and carbohydrate malabsorption. The syndrome is difficult to diagnose with accuracy using blood tests.

 

The basis for breath testing in these circumstances is that bacteria in the intestine can break down carbohydrates to produce hydrogen and methane. The sole source of these gases in alveolar air is bacterial fermentation of carbohydrate in the gut, so estimation of hydrogen and methane in breath samples can be used to study the passage of carbohydrates through the gut and the presence of pathogenic bacteria in the gastro-intestinal lumen.

 

Breath tests can be helpful in the evaluation of bloating, diarrhoea, constipation and malabsorption.

 

Breath testing to aid in the diagnosis of small intestinal bacterial overgrowth (SIBO) may also provide a framework for the understanding of irritable bowel syndrome (IBS). Recent work has demonstrated that among IBS subjects, methane production in the lactulose breath test is associated with constipation. Methane also appears to slow down the passage of food through the intestinal tract.

Cardiovascular health

CV Health Profile

Test fee (pay lab directly)

£240.00

Interpretation fee (payable to Coho once test results are available)

£80.00